Sunday, August 7, 2005

The Journal of Vascular Surgery has piece labeled a "surgical ethics challenge" about what to do about a request by a competent & terminally ill patient to turn off a pacemaker to specifically hasten his death. I'm not sure why this is in a vascular surgery journal but perhaps in some places vascular surgeons implant pacemakers? This is one of my favorite topics and there's been very little written about it. Quite a bit has been written about turning off defibrillator-cardioverters at the EOL which is "easier" ethically as getting cardioverted is certainly a "burdensome" medical intervention; whereas a pacemaker, once installed, is itself quite a low "burden" medical intervention. Requests to turn off a pacemaker are made specifically to hasten death; the "burden" is the suffering involved with the underlying illness, not the pacing. The article concludes pacing is a medical intervention like any other & thus can be stopped for whatever reason. One hopes in the next few years there won't be a Papal allocution defining pacing as a basic act of human caring & not a medical therapy...

Pallimed: A Hospice & Palliative Medicine Blog Founded June 8, 2005.
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